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Individual

SHIVENDER DESWAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
900 COOPER ST, JACKSON, MI 49202-3398
(517) 745-7575
Mailing address
900 COOPER ST, JACKSON, MI 49202-3398

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201006859
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201006859
OCCUPATIONAL THERAPIST
MI
Enumeration date
10/31/2018
Last updated
10/31/2018
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